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Informační portál europoslankyně MUDr. Zuzany Roithové na ochranu dětí před nebezpečnými výrobky a službami

od 14.9.2005


The EU is becoming a retirement home (anglický originál článku pro European Voice)

Politicians should not delay cost control reforms to cope with an ageing population just because they are unpopular, argues Zuzana Roithova. ‘The EU is becoming a retirement home. The number of seniors is increasing and the proportion of working people...is decreasing’
[ 12. dubna 2005 | Autor: ]
Europe is getting old. In the last 100 years, life expectancy has grown from 55 to 80 years. At the same time fewer children are being born so that in 2030 the population of the old continent will start to die out. Longer life expectancy reflects both a higher standard of living, which has led to great reductions in infectious deseases, and developments in medicine. Most diseases are not terminal as they once were. In some countries the population decrease can be slowed by immigration or by higher birth-rates among immigrant groups. But taken as a whole, an ageing population together with increased expectations of health services will bring to Europe social and cultural changes, great changes in health and social services system as well as, for example, in town planning and public transport. The EU is becoming a retirement home. The number of seniors is increasing and the proportion of working people – those who are creating financial resources for the more and more expensive healthcare – is decreasing. In the Czech Republic, r e t i r e m e n t – a g e d people consume 80% of health costs. This is the result of medical success rather than failure. Although the genetical predetermination of maximal life expectancy is 100 to 110 years because ageing has its biological limits, I am convinced that this trend is only approaching its peak. Politicians should not postpone the necessary cost control reforms even though they are not popular. The medical possibilities and citizens‘ desire for quality health and social services are rising faster than the financial facilities of a European society based on a solidarity principle. Public funds are created by those who are now healthy and rich, they contribute to the ill and poor. The degree of intergenerational solidarity is more distinct in the postcommunist countries than in the EU-15 and that is why the financial contrast is more obvious and getting into crisis there. It is displayed as hospital indebtedness, reduced investment in modernisation, lower salaries for medical workers and long waiting lists. The need for reform is strongest in the new member states. A high degree of solidarity is part of our Christian values on which we have built our common European house. But boundless solidarity leads to abuse and to common poverty. Experiences from socialist times in the new member countries vouch that this is not just a theory but fact. In those times the state was more responsible for health than people themselves. Services were for free and patients could not influence the price of services or the quality. Patients did not even know the price and used to visit doctors even with banal problems. This attitude survives even today when the treatment is financed from the public insurance. But attempts at reform are problematic because they are unpopular. To be effective they have to make the patient more complicit in deciding on treatment or prevention. Patients must be involved in the system as consumers of services, knowing their rights and duties, able to take part in controlling quality and costs. But they must have enough c o m p r e h e n s i b l e information. However it takes time and requires a political vision to change the patients’/voters’ ways of thinking. The new member states are closer to this vision because they are under greater economic pressure. Their experiences – the good and the bad ones – are a benefit for the rest of Europe. In addition to cost control, the objective of outside health care quality control is the most important element of medical reforms. More and more hospitals are subjecting themselves to voluntary national or international accreditation. Increasing patient mobility brings the necessity of raising confidence among patients and insurance companies in the quality and safety of services, disregarding state borders. Although national systems are different, the basic principles are similar and possible solutions are similar: cost control, greater concern for the quality of health and social care. The recent EU enlargement is an opportunity to solve it together and to multiply forces for reforming health and social care.

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